Aims To analyse the prevalence and postoperative outcomes of a particular form of epiretinal membrane (ERM) with foveoschisis-like stretched hyporeflective spaces in emmetropic eyes.
Methods A retrospective study of all consecutive eyes operated for primary ERM over a 46-month period was conducted. The presence of foveoschisis-like stretched hyporeflective spaces was assessed on the preoperative optical coherence tomography B-scan in all eyes. Highly myopic eyes were excluded. Preoperative and postoperative characteristics of eyes with foveoschisis were compared with those of a control group of 100 consecutive eyes with primary ERM without cystoid spaces.
Results Of 544 eyes with primary ERM, 17 had foveoschisis, corresponding to a prevalence of 3.1%. After a mean postoperative follow-up of 17.9±10.9 months, the foveoschisis had completely resolved in 76.5% of eyes (n=13/17). In the four eyes (23.5%) with persistent foveoschisis, the remaining hyporeflective cystoid spaces were located exclusively in the inner nuclear layer. The postoperative visual acuity and central macular thickness did not differ between both groups at the final visit. However, an acute postoperative macular oedema occurred in 24% (n=4/17) of cases (vs 3% in the control group; p=0.0084).
Conclusion Foveoschisis was found in about 3% of eyes with idiopathic ERM. After peeling, the foveoschisis usually resolves completely with functional outcomes similar to those achieved with other primary ERM. However, this feature was associated with a higher risk of postoperative macular oedema (in 1/4 of cases).
- treatment surgery
Data availability statement
Data are available on reasonable request. Data are available on request to the corresponding author.
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Contributors ML have contributed to the acquisition, analysis or interpretation of data and has draft the work. EP has contributed to the interpretation of data and has revised the work critically for important intellectual content. AG has contributed to the conception of the work, to the interpretation of data and has revised the work critically for important intellectual content. RT has contributed to the conception of the work, to the interpretation of data and has revised the work critically for important intellectual content. AC has contributed to the conception of the work, to the analysis and interpretation of data and has draft the work. All authors gave their final approval of the version published and agreed for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Disclaimer The funding organisation had no role in the design or conduct of this research.
Competing interests EP reports personal fees from Bayer and Novartis, outside the submitted work. AG reports personal fees from Novartis, Bayer Healthcare and Thrombogenics, outside of the submitted work. RT reports personal fees from Novartis, Bayer, Roche, Genentech, Allergan, Zeiss, Alcon and Oculis, outside the submitted work. AC reports personal fees from Allergan, Bayer and Novartis, outside the submitted work. All authors attest that they meet the current ICMJE criteria for authorship.
Provenance and peer review Not commissioned; externally peer reviewed.